Microbial colonization of Blom-Singer indwelling voice prostheses in laryngectomized patients: An Indian perspective

Abstract

We analyzed a series of adults with an implanted voice prosthesis that had malfunctioned and required removal as a result of the attachment and growth of microorganisms. Our goal was to determine the characteristics of these colonizing microbes. We swabbed the esophageal side of each prosthesis to obtain microbial flora for analysis with standard culture media. In all, we studied 22 prostheses in 18 patients (3 patients had received multiple prostheses). We found mixed contamination (both yeast and bacteria) in 19 of the 22 cultures (86.4%); the other 3 cultures yielded bacteria only, and there was no instance of yeast only. The most common yeast isolated was Candida albicans (68.2% of cultures), and the most common bacterium was Pseudomonas aeruginosa (63.6%). The average lifetime of the prostheses was 201 days (∼6 mo, 3 wk). This study, which was the first of its kind in India, revealed that the microbial picture here was different from that found in previously reported studies of European populations. We presume the differences are attributable to different lifestyles and dietary habits.

Introduction

Voice rehabilitation in a laryngectomized patient can be achieved in a variety of ways, but the best voice quality is achieved by placing a prosthesis through a tracheoesophageal puncture (TEP).1 Objectively, TEP speech is much superior to esophageal speech and artificial-larynx speech, and success rates have been reported to be as high as 90%.2,3 However, the utility of the implanted voice prosthesis is often hampered by the attachment and growth of biofi

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